<!DOCTYPE html>
<html>
<head>
    <meta charset="utf-8">
    <meta name="viewport" content="width=device-width,initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=no,minimal-ui">
    <meta name="apple-mobile-web-app-capable" content="yes" />
    <meta name="apple-mobile-web-app-title" content="贝生云随访">
    <title></title>
    <link rel="stylesheet" href="page/res/css/plugins/jquery.fonticonpicker.min.css" />
    <link rel="stylesheet" href="page/res/css/font-awesome.min.css"/>
    <link rel="stylesheet" href="page/res/css/bootstrap.min.css" />
    <link rel="stylesheet" href="page/followup/css/common/common.css">
    <link rel="stylesheet" href="page/patientsQuestionnaire/css/patientsLogin.css" />
</head>
<body>
    <div class="clearfix login_area">
        <div class="login">
            <div class="text-center f-18">卵巢早衰项目</div>
            <div class="text-center f-22">患者自助问卷</div>
            <div class="form_login">
                <div class="message"></div>
                
                <div class="form-row">
                    <div class="form-icon"><i class="fa fa-user-o" aria-hidden="true"></i></div>
                    <div class="form-input">
                        <input type="text" name="username" class="form-control" placeholder="请输入姓名"/>
                    </div>
                </div>
                
                <div class="form-row">
                    <div class="form-icon"><i class="fa fa-mobile" aria-hidden="true"></i></div>
                    <div class="form-input">
                        <input type="text" name="phone" class="form-control" placeholder="请输入手机号"/>
                    </div>
                </div>
                <div class="form-row">
                    <div class="form-icon"><i class="fa fa-lock" aria-hidden="true"></i></div>
                    <div class="form-input w-45">
                        <input type="text" name="code" class="form-control" placeholder="请输入验证码"/>
                    </div>
                    <div class="identifyingCode" id="identifyingCode">获取验证码</div>
                </div>
                <div class="text-center form-submit">
                    <button class="btn btn-yellow" id="toSubmit">登录</button>
                </div>
            </div>
        </div>
        <div class="hospital_info">
            <div class="hospital_name">
                <span class="hospital_logo"><img src="page/patientsQuestionnaire/img/logo.png" alt=""/></span>国际和平妇幼保健院
            </div>
        </div>
    </div>
    <div id="input_area" class="clearfix input_area"></div>
</body>
<script data-main="scprit/patientsLogin" src="scprit/libs/require.js"></script>
</html>
